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(Please attach a list of additional Corporate or DBA/Trade Names)
Address

Please select business type:

Financing Requested

Have you worked with a Factor before?
Are your receivables pledged as collateral?
Has the company been involved in any litigation, either currently or historically?
Has the company ever filed for bankruptcy or filed a proposal for bankruptcy?

Banking Information

Do you have any financing facilities with this bank or other lenders?

Principals of The Company

Home Address
Rent or Own
Signing Authority

Home Address
Rent or Own
Signing Authority
Have the owners, officers or key managers of the company ever been convicted of a criminal offense?

List all Subsidiaries and related Corporations


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Do you use a payroll service?

Details of Tax Status

Indicate approximate amount due. If no arrears, type Nil

Certification

The foregoing information is true and correct to the best of my knowledge and is given to induce Express Business Funding (The EBF Group Ltd.) to consider entering into a financing agreement with this company. I hereby authorize Express Business Funding (The EBF Group Ltd.), Aird & Berlis LLP., and or its agents, to verify and investigate any or all of the foregoing statements, including but not limited to my/our creditworthiness and financial responsibility, in any way they may choose. I/We grant Express Business Funding (The EBF Group Ltd.), Aird & Berlis LLP., and or its agents, the right to procure any and all credit reports pertaining to any party listed in this application, including, but not limited to, all principals of the applicant company.

I consent to Express Business Funding (The EBF Group Ltd.) and its affiliates sending me electronic messages with respect to the services provided by them. I understand that I may withdraw my consent at any time.


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Supporting Documentation Checklist


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Supporting Documentation Checklist

Have you sent us all the Supporting Documentation?

Please be sure to send all supporting Documentation to info@ebf.ca followed by your Principal Signature/s.

(Please attach a list of additional Corporate or DBA/Trade Names)
Address

Please select business type:

Financing Requested

Have you worked with a Factor before?
Are your receivables pledged as collateral?
Has the company been involved in any litigation, either currently or historically?
Has the company ever filed for bankruptcy or filed a proposal for bankruptcy?

Banking Information

Do you have any financing facilities with this bank or other lenders?

Principals of The Company

Home Address
Rent or Own
Signing Authority

Home Address
Rent or Own
Signing Authority
Have the owners, officers or key managers of the company ever been convicted of a criminal offense?

List all Subsidiaries and related Corporations

Do you use a payroll service?

Details of Tax Status

Indicate approximate amount due. If no arrears, type Nil

Certification

The foregoing information is true and correct to the best of my knowledge and is given to induce Express Business Funding (The EBF Group Ltd.) to consider entering into a financing agreement with this company. I hereby authorize Express Business Funding (The EBF Group Ltd.), Aird & Berlis LLP., and or its agents, to verify and investigate any or all of the foregoing statements, including but not limited to my/our creditworthiness and financial responsibility, in any way they may choose. I/We grant Express Business Funding (The EBF Group Ltd.), Aird & Berlis LLP., and or its agents, the right to procure any and all credit reports pertaining to any party listed in this application, including, but not limited to, all principals of the applicant company.

I consent to Express Business Funding (The EBF Group Ltd.) and its affiliates sending me electronic messages with respect to the services provided by them. I understand that I may withdraw my consent at any time.

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